scholarly journals Clinical outcome of design modifications to the CLS Spotorno Stem in total hip replacement

Joints ◽  
2016 ◽  
Vol 04 (03) ◽  
pp. 134-141 ◽  
Author(s):  
Angelo Graceffa ◽  
Pier Indelli ◽  
Leonardo Latella ◽  
Paolo Poli ◽  
Alexander Fulco ◽  
...  
Keyword(s):  
Intraoperative Complications ◽  
Harris Hip Score ◽  
Consecutive Series ◽  
Femoral Offset ◽  
Stem Design ◽  
Total Hip ◽  
Post Surgery ◽  
The Mean ◽  
Hip Rotation

Purpose: historically, the original CLS Spotorno Stem has demonstrated excellent survival. The design of this stem was recently modified, resulting in the introduction of a shorter, modular version (CLS Brevius). The purpose of the current study was to evaluate the functional, radiological and survivorship outcomes of the cementless CLS Brevius Stem in a multi-surgeon, single center, consecutive series study at two years post-surgery. Methods: the Authors performed 170 total hip arthroplasties in 155 patients using the shorter, tripletaper stem design (CLS Brevius). The patients’ diagnoses were primary hip osteoarthritis (OA) in 74.4%, secondary hip OA in 22.6%, and post-traumatic hip OA in 3%. All operations were performed through a mini-posterior approach, with the patient in the lateral decubitus position. The mean follow-up was 32 months (24-44 months). Outcome was assessed using the Harris Hip Score (HHS). Results: the mean HHS improved from 32 preoperatively to 92 points at final follow-up, while the stem survival rate was 99.4%.Overall, the results were excellent in148 hips (87%), good in 14 hips (8.2%), fair in six hips (3.6%), and poor in two hips (1.2%). Intraoperative complications included a calcar fissure in three hips (1.7%). Correct femoral offset was reproduced in 97% while the planned center of hip rotation was achieved in 98%. Only one hip underwent early stem revision; this was due to major subsidence. Conclusions: the modified CLS stem design showed excellent short-term results with a low rate of early postoperative complications. One of the main findings of this study was the high correlation between the planned femoral offset and center of hip rotation and the final radiographic measurements. This high reproducibility, which indicates the ability of the system to restore normal hip anatomy, is indeed due to the extensive modularity that characterizes this stem system. Long-term follow-up studies are necessary to fully compare the outcomes of the new design with its highly successful predecessor. Level of Evidence: Level IV, therapeutic cases series.

scholarly journals Primary Total Hip Arthroplasty Using an Uncemented Wagner SL Stem in Elderly Patients With Dorr Type C Femoral Bone

2018 ◽  
Vol 103 (5-6) ◽  
pp. 287-294
Author(s):  
Ping Zhen ◽  
Jun Liu ◽  
Hao Lu ◽  
Hui Chen ◽  
Xusheng Li ◽  
...  
Keyword(s):  
Lateral View ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Femoral Bone ◽  
Stem Design ◽  
Total Hip ◽  
Type C ◽  
The Mean ◽  
Hip Arthroplasties

The purpose of this study was to review retrospectively the primary total hip arthroplasties operated upon with the cementless Wagner self-locking stem in patients with Type C femoral bone. Twenty-five total hip arthroplasties were performed in 23 patients aged ≥60 years using a cementless Wagner self-locking femoral component between 2006 and 2011. According to Dorr's criteria, all 25 femora were classified as type C bone. Mean follow-up period was 62 months (range, 47–85 months). Average Harris Hip score preoperatively was 46 ± 9 (range, 39–62) and at the last follow-up was 90 ± 9 (range, 83–98). The mean proximal stem-to-canal fill percentage was 95% ± 3.5% (anteroposterior view) and 90% ± 2.8% (lateral view) and the mean distal canal fill was 93% ± 4.5% (anteroposterior) and 92% ± 3.9% (lateral). Radiographic evaluation demonstrated good osteointegration of the implants in follow-up. Based on the long-straight cylindrical tapered stem design, the cementless Wagner SL stem can achieve reliable stability by close apposition of stem and wide stovepipe femoral canal from metaphysis to diaphysis in Type C bone.

scholarly journals Augmenting Osteointegration of Proximal Femoral Endoprosthesis Using Porous Titanium Bridging Endosteal Collars: preliminary medium-term results

2021 ◽  
Author(s):  
Raja Bhaskara Rajasekaran ◽  
Thomas William Hamilton ◽  
Duncan Whitwell ◽  
Ben Kendrick ◽  
Adrian Taylor ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Case Series ◽  
Porous Titanium ◽  
Harris Hip Score ◽  
Consecutive Series ◽  
Radiographic Assessment ◽  
Medium Term ◽  
Post Surgery ◽  
The Mean

Abstract Background Aseptic loosening remains a major cause for failure of proximal femoral replacements (PFR). To reduce the incidence of aseptic loosening a PFR was developed with a selective laser sintered, porous titanium-bridging collar and endosteal component. This study reports the short-term outcomes of this implant in a consecutive series of patients. Methods Between October 2017 and August 2019, 24 patients, mean age 69 years (50–84) were managed using this PFE for a variety of aetiologies (10 oncological, 10 revision of aseptic loosening, 3 fracture non-union, and 1 for prior infected joint replacement). Patients were followed up at a mean of 24 months (16–34) with a clinical and radiographic assessment. Results Twenty-three patients were available for follow-up with one death in the early postoperative period. One patient died 18 months post-surgery due to causes unrelated to surgery, two cases of superficial infection were managed with antibiotics and two cases of deep infection managed with debridement, antibiotics, and implant retention (DAIR). At the last follow up the mean Harris Hip Score was 78 (68–86) and the mean Musculoskeletal Tumour Society Score was 20 (16–24). The radiographic assessment did not reveal any evidence of loosening with the integration of the endosteal collar observed in all cases. Conclusions Our medium-term results demonstrate good functional outcomes with no evidence of radiographic loosening and osteointegration of the endosteal collar in a consecutive series of patients. Further studies are required to assess the mid to long-term outcomes seen with this implant. Level of Evidence: Level IV – Retrospective Case Series

scholarly journals Primary total hip arthroplasty using an uncemented Wagner SL stem in elderly patients with Dorr type C femoral bone

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Ping Zhen ◽  
Jun Liu ◽  
Xusheng Li ◽  
Hao Lu ◽  
Shenghu Zhou
Keyword(s):  
Lateral View ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Femoral Bone ◽  
Stem Design ◽  
Total Hip ◽  
Tapered Stem ◽  
Type C ◽  
Hip Arthroplasties

Abstract Background The purpose of this study was to review retrospectively the primary total hip arthroplasties operated upon with the cementless Wagner Self-Locking stem in patients with type C femoral bone. Methods Twenty-eight total hip arthroplasties were performed in 25 patients aged ≥ 60 years using a cementless Wagner Self-Locking femoral component between 2006 and 2011. According to Dorr’s criteria, all 28 femora were classified as type C bone. All patients were treated with THA using a cementless Wagner cone prosthesis. Clinical and radiologic evaluations were performed on all patients. Results Mean follow-up period was 125 ± 10.5 months (range 96 to 156 months). Average Harris hip score pre-operatively was 46 ± 9 (range 39 to 62) and at the last follow-up was 90 ± 9 (range 83 to 98). The stem to canal fill is calculated as percentages on the operative side at three distinct levels: just below the lesser trochanter, at midstem, and 1 cm above the tip of the component on anteroposterior radiograph. The mean proximal stem-to-canal fill percentages were 97% ± 2.1%, 95% ± 3.5%, and 88% ± 2.6%, respectively (anteroposterior view) and 92% ± 2.2%, 86% ± 1.9%, and 83% ± 2.5%, respectively (lateral view). Radiographic evaluation demonstrated good osteointegration of the implants in the follow-up. Conclusions Based on the long-straight cylindrical tapered stem design, the cementless Wagner SL stem can achieve reliable stability by close apposition of the stem and wide stovepipe femoral canal from metaphysis to diaphysis in type C bone.

scholarly journals 32-mm ceramic-on-ceramic total hip arthroplasty versus 28-mm ceramic bearings: 5- to 15-year follow-up study

2018 ◽  
Vol 29 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Yoshitoshi Higuchi ◽  
Taisuke Seki ◽  
Yukiharu Hasegawa ◽  
Yasuhiko Takegami ◽  
Daigo Morita ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Total Hip ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Average Patient ◽  
The Mean ◽  
Ceramic On Ceramic

Introduction: This study aimed to compare the clinical and radiographic results of 28-mm ceramic-on-ceramic (CoC) total hip arthroplasty (THA) to those of 32-mm CoC during a 5- to 15-year follow-up period. Methods: 107 joints (95 women and 6 men) underwent 28-mm CoC, and 60 (49 women and 7 men) underwent 32-mm CoC. The average patient age at the time of surgery was 56.1 and 55.7 years in the 28-mm and 32-mm CoC groups, respectively. Clinical and radiologic measurements of all patients were analysed. Results: The mean preoperative Harris hip score (HHS) was similar in the 2 groups (28-mm, 58.9; and 32-mm, 58.5). However, at final follow-up, the mean HHS of the 32-mm CoC (91.8) was significantly better than that of the 28-mm CoC (88.2) ( p = 0.003), as were the ranges of motion (ROM) for flexion (98.3 ± 13.5° vs. 87.3 ± 19.3°, p < 0.001) and abduction (27.8 ± 14.9° vs. 22.1 ± 19.3°, p = 0.007). The mean wear rate was 0.0044 mm/year for the 28-mm CoC and 0.0044 mm/year for the 32-mm CoC. No ceramic fractures were found in the 2 groups. One joint in the 28-mm CoC (0.9%) required revision owing to progressive osteolysis. Kaplan-Meier survival at 10 years, with implant loosening or revision THA as the endpoint, was 98.3% for 28-mm CoC and 100% for 32-mm CoC ( p = 0.465). Conclusion: There was no significant difference in ceramic-related complications between the 2 groups. Our study demonstrated that the 32-mm and 28-mm CoC are safe and are associated with good clinical outcomes.

Good mid-term clinical results of a cemented dual mobility cup: a single-centre experience

2017 ◽  
Vol 28 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Gregor Kavčič ◽  
Pika Mirt ◽  
Klemen Bedenčič
Keyword(s):  
Final Analysis ◽  
Clinical Results ◽  
Harris Hip Score ◽  
Consecutive Series ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Single Centre Experience ◽  
The Mean ◽  
Hip Arthroplasties

Introduction and methods: From January 2004 to December 2008, 188 total hip arthroplasties were performed using a cemented dual mobility cup. 174 patients were available for final analysis. Their mean age was 76.8 (range 54-98 years). The mean follow-up was 7.7 years (range 5-10 years). Results: There were no dislocations. Survivorship rates of the femoral and acetabular components were 100% at a minimum of 5 years. At the latest follow-up, the mean Harris Hip Score significantly increased from 31.6 (only arthritic patients) points preoperatively to 84.5 points. No patients had progressive osteolysis, component migration, or loosening on radiographs. 2 patients presented with periprosthetic fractures treated conservatively. 2 patients presented with infection treated without implant removal and 1 patient presented with transient femoral palsy. Conclusions: The results of this consecutive series confirmed the good performance of the cemented dual mobility cup at mean 7.7 years follow-up with no revision and no dislocations.

scholarly journals Catastrophic Failure and Metallosis of the Acetabular Component in Total Hip Arthroplasty

2021 ◽  
Author(s):  
FIRAT OZAN ◽  
Murat Kahraman ◽  
Ali Baktır ◽  
Kürşat Gençer
Keyword(s):  
Revision Arthroplasty ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Catastrophic Failure ◽  
Total Hip ◽  
Catastrophic Failures ◽  
Revision Tha ◽  
The Mean ◽  
Hip Arthroplasties

Abstract Background: To evaluate the clinical features and results of the revision total hip arthroplasties (THA) in patients with catastrophic failures and metallosis. Methods: Fifteen hips of 14 patients with catastrophic failure and metallosis in hip arthroplasties were evaluated. They were followed for at least 4.2 years after the revision THA. Clinical evaluation was performed using Harris hip score. Osteolysis, loosening or presence of metallosis was evaluated with standard radiographs. Metallosis was evaluated intraoperatively according to the metallosis severity classification. Results: The mean time from failure until revision surgery was 9.4 years. It was observed that in the primary THA, metal-on-ceramic (MoC), ceramic-on-ceramic (CoC) and metal-on-conventional polyethylene (MoCPE) bearings were used in 1, 3 and 11 hips, respectively. Grade III metallosis was observed in all patients during revision surgeries. The mean Harris hip score increased from 55 points before revision THA to 75 points at the final follow-up. In revision arthroplasty, MoCPE and CoC bearings were used in 13 and 2 hips, respectively. The femoral stem was replaced in 5 hips. All acetabular cups, except that of one hip, were revised. Conclusions: Revisions of THAs with catastrophic failures and metallosis are quite challenging. Routine follow-up of arthroplasty patients is beneficial to examine for osteolysis, loosening, and asymmetric wear.

Use of telephone interviews to follow up patients after total hip replacement

2005 ◽  
Vol 11 (4) ◽  
pp. 211-214 ◽  
Author(s):  
Sanjeev Sharma ◽  
Ravi Shah ◽  
Kingsley Paul Draviraj ◽  
M S Bhamra
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Harris Hip Score ◽  
Face To Face ◽  
Total Hip ◽  
Telephone Interviews ◽  
Significant Difference ◽  
The Mean ◽  
The Individual

We studied the feasibility of telephone interviews to assess hip function in patients who had had a total hip replacement. One hundred patients attending the orthopaedic clinic for follow-up after undergoing total hip replacement were studied. A modified Harris hip score was used. Since range of motion and deformity cannot be assessed by telephone, only pain and function were assessed. The maximum possible score was 100. Patients attending follow-up clinics were contacted by telephone one to two weeks prior to their appointment and a telephone assessment was completed. This was then compared with a face-to-face assessment in the subsequent clinic. The mean hip score obtained with the telephone interview was 85.2 and the mean hip score at face-to-face assessment was 86.1. The mean of the differences between the individual scores was −0.9 (SD 5.5). This difference was not significant ( P=0.11). Only three patients had a clinically significant difference (>20 points) between the two methods. Telephone questionnaires may be a useful adjunct to face-to-face assessment for patient follow-up after total hip replacement.

scholarly journals Primary hip arthroplasty for the treatment of alkaptonuric hip arthritis: 3- to 24-year follow-ups

Arthroplasty ◽  
2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Javahir A. Pachore ◽  
Vikram Indrajit Shah ◽  
Sachin Upadhyay ◽  
Kalpesh Shah ◽  
Ashish Sheth ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Harris Hip Score ◽  
Daily Routine ◽  
Total Hip ◽  
Hip Arthritis ◽  
Primary Osteoarthrosis ◽  
The Mean ◽  
Level Of Significance

Abstract Background The objective of this study is to share our experience in total hip replacement for the treatment of ochronotic hip arthritis, in particular to report how to establish the diagnosis and some tips to limit complications. Method A cohort comprised of 10 patients (12 hips) with alkaptonuric hip arthritis. There were six men and four women with the mean age of 62.80 ± 7.57 years. All patients had a stiff spine, grossly restricted movements of hip joints, and severely limited daily routine activities. Total hip replacement was performed in all patients. The patients were evaluated at 6, 12, and 24 months after surgery, as well as every 4 years thereafter. Harris hip score was used to assess the functional outcome. The level of significance was set at p < 0.05. Results The mean follow-up lasted 16.70 ± 6.82 years (3 to 24 years). At the final available follow-up, nine patients returned to work, ambulate without an orthosis, and achieve complete pain relief. Harris hip score was improved from poor to excellent. One patient died 16 years after surgery due to breast cancer. No complication relating to prosthetic failures was detected. Conclusion Total hip replacement gives long-term satisfactory results in patients with alkaptonuric hip arthritis, resulting in comparable function of the hips in patients who undergo primary osteoarthrosis.

scholarly journals Total hip arthroplasty after hip joint gunshot injury

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987311 ◽  
Author(s):  
Ozhan Pazarci ◽  
Seyran Kilinc ◽  
Yalkin Camurcu ◽  
Okay Bulut
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Short Form ◽  
Gunshot Injury ◽  
Harris Hip Score ◽  
Joint Region ◽  
Total Hip ◽  
The Mean

Background: Gunshot injury of the hip joint was reported to constitute 2–17% of all extremity firearm injuries. However, there are few studies in the literature related to gunshot injuries of the hip joint. The aim of the current study was to present the results of 10 cases treated with arthroplasty following a gunshot injury to the hip joint together with the recommended treatment algorithm. Methods: Patients with a previous medical history of hip joint region gunshot injury who underwent total hip arthroplasty were retrospectively evaluated. Those with incomplete medical records or who were lost to follow-up were excluded. Patients were classified according to the severity of the previous gunshot injury to the hip joint region. Harris hip score (HHS) and Short Form-12 quality of life score were the main outcome measurements. Postoperative complications encountered during follow-up were recorded. Results: The mean age of the patients at the time of surgery was 29.9 years. The mean preoperative HHS was 25.2 points and it was 65.8 at the final follow-up. Patients with bullet fragments in the hip joint, classified as group 1, had better HHS, whereas those with contaminated hip joint with intestinal flora, classified as group 3, had worst HHS. Conclusion: Hip arthroplasty after hip joint gunshot injury is a good treatment choice in young patients to reduce pain and regain functions. However, very high infection rates can be seen in patients with accompanying intestinal injury.

scholarly journals Preliminary Outcomes of the Cementless UNITED Hip System for primary Total Hip Arthroplasty at a Minimum Two-year Follow-up

2020 ◽  
Author(s):  
Fernando Diaz Dilernia ◽  
Agustin Garcia-Mansilla ◽  
Agustin Albani-Forneris ◽  
Pablo Slullitel ◽  
Gerardo Zanotti ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acute Infection ◽  
Periprosthetic Femoral Fracture ◽  
Consecutive Series ◽  
Total Hip ◽  
Implant Retention ◽  
The Mean ◽  
Primary Total Hip Arthroplasty

Abstract Introduction: This study aimed to report the initial results of the cementless UNITED hip system in primary total hip arthroplasty (THA) with a minimum follow-up of 2 years. Methods We retrospectively studied a consecutive series of 203 cementless THAs in 180 patients operated between 2015–2017. We included 89 female and 91 male patients with a mean age of 67 (28 to 89) years. The mean follow-up was 40 (29 to 62) months. Clinical outcome scores and radiographs were measured. Survival was calculated defining failure as the need for any further femoral or acetabular revision, irrespective of the reason. Results No femoral component loosening was detected. One patient had a Vancouver-B1 intraoperative periprosthetic femoral fracture treated with implant retention and cerclage wires. Two acetabular components were revised for aseptic loosening. Three patients suffered an acute infection treated with debridement, antibiotics, and implant retention. The mean Merle d'Aubigné et Postel scores improved from 13 (4 to 16) points preoperatively to 17 (12 to 18) points at the latest follow-up (p < 0.001). At a mean time of 40 months of follow-up, the survival was 99% and 100% for the acetabular and the femoral components, respectively. Conclusion This cementless design showed excellent preliminary outcomes in terms of fixation and patient satisfaction, comparable to that of other well-known similar systems.

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